不同手术治疗精索静脉曲张不育的效果及多因素分析  

Effects and Multivariate Analysis of Different Surgeries for Varicocele Infertility

作　　者：吴相瑞 王泳[1] 闫厚煜 WU Xiangrui;WANG Yong;YAN Houyu(Department of Andrology,Jian'ou Municipal Hospital,Jian'ou Fujian 353100,China)

机构地区：[1]建瓯市立医院男科,福建建瓯353100

出　　处：《中国卫生标准管理》2023年第18期98-101,共4页China Health Standard Management

摘　　要：目的探讨腹膜精索静脉高位结扎术与显微镜手术治疗精索静脉曲张不育患者的临床效果,并分析两种手术疗效的影响因素。方法将建瓯市立医院2021年1月—2022年12月收治的150例精索静脉曲张不育患者纳入本研究,入选患者以随机数字表法分为两组,即观察组与对照组。对照组(n=75)行腹膜精索静脉高位结扎术治疗,观察组(n=75)开展显微镜手术治疗。比较两组患者的总有效率、术后并发症发生情况。将总有效和无效者分为成功组(n=130)与失败组(n=20),借助单因素与多因素回归分析两种手术疗效的影响因素。结果观察组患者的总有效率为93.33%,与对照组的80.00%比较,差异有统计学意义(P<0.05)。观察组患者的并发症总发生率为5.33%,与对照组的24.00%比较,差异有统计学意义(P<0.05)。成功组与失败组患者年龄、合并疾病、精索静脉曲张程度、手术方式相比较,差异有统计学意义(P<0.05);将单因素分析中差异有统计学意义项目纳入二元Logistic回归模式中,结果显示,年龄≥30岁、合并疾病、Ⅲ级精索静脉曲张、腹膜精索静脉高位结扎术为手术疗效的独立危险因素,差异有统计学意义(P<0.05)。结论与腹膜精索静脉高位结扎术相比,显微镜手术治疗精索静脉曲张不育患者有效,术后并发症少。且年龄≥30岁、Ⅲ级精索静脉曲张、合并疾病、腹膜精索静脉高位结扎术是影响手术疗效的独立危险因素。Objective To explore the clinical efficacy of high peritoneal spermatic vein ligation and microscopic surgery in patients with varicocele infertility,and to analyze the factors affecting the efficacy of microscopic surgery.Methods A total of 150 patients with varicocele infertility admitted to Jian'ou Municipal Hospital from January 2021 to December 2022 were included in this study.The selected patients were divided into two groups by random number table method,namely observation group and control group.The control group(n=75)underwent high peritoneal spermatic vein ligation,and the observation group(n=75)underwent microscopic surgical treatment.The total response rate and the occurrence of postoperative complications were compared between the two groups.The total response and ineffective patients were divided into success groups(n=130)and failure groups(n=20),and the effects of the two procedures were analyzed by univariate and multifactorial regression.Results The total effective rate of observation group was 93.33%,compared with 80.00%of control group,the difference was statistically significant(P<0.05).The total incidence of complications in the observation group was 5.33%,compared with 24.00%in the control group,the difference was statistically significant(P<0.05).There were significant differences in age,disease,varicocele degree and operation method between successful group and failed group(P<0.05).Items with statistical significance in univariate analysis were incorporated into the binary Logistic regression model.The results showed that age≥30 years old,complicated diseases,gradeⅢvaricocele and peritoneal high ligation of spermatic vein were independent risk factors for surgical efficacy,the differences were statistically significant(P<0.05).Conclusion Compared with high ligation of the peritoneal spermatic vein,microscopic surgery is effective in treating patients with varicocele infertility,with fewer postoperative complications.And age≥30 years,gradeⅢvaricocele infertility,other diseases,and h

关 键 词：腹膜精索静脉高位结扎术 显微镜手术 精索静脉曲张不育 临床疗效 多因素分析 并发症 

分 类 号：R697[医药卫生—泌尿科学]